We could see the tension in the room. He was livid, and they had no answers, as usual. The usual dhamkis of making good losses from salary cuts were brandished, yet another final warning was issued, and the gathering was dismissed.

What had caused such misery in an already tiring and monotonous day you ask? An expensive instrument had returned damaged. And both parties in the exchange were blaming the other. On further probing it transpired that the man in question had lost it also because of an earlier complaint from a surgeon – “I never have the instruments I want” was his basic rant.

I am wondering how this man expects instruments never to break given that the hospital performs 25 surgeries a day and these instruments are handled several times by several people during each use.

I am thinking in my mind, there is not a week that passes at home without a cup breaking or (God forbid) an expensive show piece develops a crack in an unexplained way! And that’s when a limited number of people handle these. So, what can explain the extreme reactions of this man to something that is, well, to be expected?!

The answers came through our work at hospitals and observing the instrument management processes up close. Hospitals spend upwards of 10-15% (on a conservative basis) of their procurement / replacement budgets on instrumentation year after year and the one recurrent theme we have found is a complete lack of visibility of value… There are no answers to simple questions:

1.    What is the current level of my inventory?

2.    What is the frequency of replacements – are most replacements driven by breakages or by wear and tear? What is the failure rate?

3.    What is the life of items of inventory? What is the usage?

4.    Is inventory going missing – what is the rate of misplacement? Is it going up annually or down or where?

Isn’t it time that this changed? In a day and age when everything is digitized including the reminders that occasionally pop up on our phones or the wearable device that reminds you to get up and take a walk, can it be acceptable that instrument inventory, covering thousands of line items with their complex cleaning and disinfection routines are still monitored through registers, phone calls and the like? Time to Pivot, Pivot Smartflow